go back

Montana rates for HCPCS Q4156

Neox 100 or Clarix 100, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $74 · 10th–90th $66–$2040%20%10th90th$74Professionalmedian $66 · 10th–90th $65–$1260%50%10th90th$66$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $181.97
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $79.43 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89